Chondroitin sulfate is a popular supplement used treat the pain and loss of function associated with osteoarthritis, or OA, but studies assessing its effectiveness have been mixed. A study published online in Arthritis & Rheumatism adds one more piece to the chondroitin puzzle, finding that the supplement appears to safely relieve some symptoms of hand OA.

“Hand osteoarthritis is a frequent form of arthritis that can be very painful and is also associated with a significant impact on quality of life,” explains lead author Cem Gabay, MD, professor of medicine at the University of Geneva School of Medicine and head of the division of rheumatology at the University Hospitals of Geneva, Switzerland. Hand arthritis affects 20 to 30 percent of adults, and more than 50 percent of those age 60 and older.

The body naturally makes chondroitin, a molecule that is a major component of cartilage and helps cartilage retain water. It also can be manufactured from the cartilage of animals – like cows, pigs or sharks – or made synthetically. The supplement is sold as chondroitin sulfate. In many European countries it is approved as a prescription treatment for OA. In the U.S., it is often combined with a glucosamine supplement. Like chondroitin, glucosamine is a natural compound found in healthy cartilage.

The new study – a randomized, placebo-controlled, double-blinded trial – involved 162 patients older than age 40 with hand OA. Eighty participants were given a daily 800 mg dose of chondroitin sulfate (derived from fish) for six months; 82 patients received a placebo.

Compared with those taking a placebo, participants taking the supplement had a statistically significant decrease in hand pain and improvement in hand function at the end of the study. The researchers write that these improvements “started to become evident after 3 months of treatment.” Chondroitin-takers also experienced significantly shorter duration of morning stiffness. There were no differences in grip strength, the use of pain rescue medication (acetaminophen) or side effects.

Dr. Gabay says the findings show that chondroitin’s effect is similar in magnitude to that of nonsteroidal anti-inflammatory drugs, or NSAIDs, but has fewer risks. As the researchers wrote, chondroitin has not been compared head-to-head to NSAIDs, but three other studies of NSAIDs’ effects on hand OA measured a similar improvement in hand pain and function scores.

“The positive effects of NSAIDs appear more rapidly than those observed with chondroitin sulfate,” says Dr. Gabay. “However, NSAIDs are associated with significant side effects, in particular in elderly patients.”

In 2009, the American Geriatrics Society took NSAIDs off the list of medicines recommended to treat persistent pain in older patients because of an increased risk of gastrointestinal bleeding, heart attack or stroke. NSAIDs also don’t interact well with many of the drugs taken for conditions commonly associated with aging, such as heart failure medication.